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Scaling EUROpean citizen driven transferable and transformative digital integrated health and social care

Periodic Reporting for period 1 - SEURO (Scaling EUROpean citizen driven transferable and transformative digital integrated health and social care)

Reporting period: 2021-05-03 to 2022-11-02

An estimated 50 million people in the EU (60% aged over 65) live with multiple chronic diseases, which deeply impact quality of life. Annually chronic disease management is estimated to cost €700 billion (70-80% of healthcare costs) in the European Union (EU). On top of this the EU faces strong concerns over the sustainability of health services due to increasing healthcare expenditure, as well as disparities in the number of practicing health professionals. To successfully deliver new innovative (sustainable and efficient) models of care for multimorbidity, the EU must advance the use of digital health technologies, to empower citizens to play an active role in home based self-management and care practices. Embracing digital solutions has the potential improve the quality of life of EU citizens living with multimorbidity and facilitate healthcare systems to more effectively de-centralise health and social care to the community.

‘SEURO’ ( aims evaluate key factors necessary to prepare any EU region to successfully implement, transfer and scale innovative digital health solutions for multimorbidity management. This will be achieved via the development and implementation of three new digital organisational self-assessment tools: ProTransfer, ProBCF-C and ProInsight with the ProACT platform. ProACT is a digital platform to improve home-based self-management and care for older adults (over 65 years) with multimorbidity (focus was on diabetes, chronic heart disease/failure and chronic obstructive pulmonary disease (COPD)), which was successfully developed at a proof of concept level under a previous Horizon 2020 project called ProACT (Grant No 689996, please see: The SEURO project will continue to develop and evaluate the ProACT platform with the 3 new organisational self-assessment tools via trials in Ireland, Belgium, Sweden and Italy with older adults with multimorbidity and their care networks. To achieve the project aim, SEURO will address seven objectives:

1. Adapt and deploy a transferability self-assessment tool (ProTransfer) to evaluate organisational and local/regional specific readiness for the transferability of ProACT.
2. Implement and evaluate a Behavioural Change Framework (ProBCF) to maximize effective user engagement and scalability of a digital health solution in a ‘Real World’ deployment.
3. Evaluate, via 3 ‘Effectiveness-Implementation Hybrid (EIH) Trials’ within and across country transfer, sustainability and scalability of ProACT (including use with vulnerable populations).
4. Develop a systematic approach for evaluating and assessing organisational/local/regional preparedness using a digital IntC system.
5. Develop further the ProACT platform for managing multimorbidity at scale. SEURO will seek to advance the analytic capabilities of the ProACT platform developed under the H2020 project.
6. Conduct an inductive simultaneous exploratory (ISE) trial (in Italy) to validate ProTransfer, ProBCF and ProInsight and to explore the compatibility of ProACT with existing requirements and constraints of local/regional/national and international procurement processes.
To date SEURO has successfully advanced all 7 key objectives. This has included:

• In consultation with EU and international experts the development of three new digital implementation support tools (SEURO tools) to improve organisation/service readiness to transfer and scale digital health interventions. This includes:

1. ProTransfer: organisational self-assessment tool to help evaluate preparedness for transferring a digital health solution into practice.
2. ProBCF-C: a checklist to help optimise and sustain behaviour change using a digital health solution.
3. ProInsight: an artificial intelligence (AI) prediction model to assess the impact of a digital health solution on health system performance.

• Redevelopment of the ProACT platform to more comprehensively address transferability and scalability.

• Set up (including ethical approvals) for trials in Ireland, Belgium and Sweden. The trials aim to measure ProACT platform effectiveness and better understand implementation of the platform in a ‘real world’ context. Trials will include 720 older adults (aged 65 and older) with multimorbidity and their associated care network support actors.

• Initial set up for an exploratory trial in Italy to evaluate the use of the SEURO tools to advance the procurement process for digital health interventions across the EU to ensure tender specifications are designed to maximise the ability of organisations to successfully implement and transfer of digital health solutions.

• Outcomes from SEURO to date have been significant raising the profile of the project across the EU and internationally (including: 10 scientific publications, 18 conference presentations, 18 press releases, 15 education/training events held and 3692 key stakeholders engaged via trial site visits etc). SEURO researchers also received the ‘Silver Eco and Ageing Well International Award’ in recognition of the project as key to advancing innovation in the field of ageing well

• Finally, initial steps have been taken to formulate a road-map for future roll out of the SEURO tools and ProACT platform across the EU. Outcomes from the project trials will help shape this strategy and will be reported at the end of the project.
SEURO has utilised the state of the art in software development, cloud computing, artificial intelligence and behavioural science to develop a novel digital health platform ‘ProACT’ to support home based self-management of multimorbidity, with 3 tools to help organisations and services improve their readiness to adopt, transfer and scale such solutions in practice. Overall there are 3 key expected outcomes from the project:

• Evaluation of the potential effectiveness and transferability of the ProACT platform as a digital health solution to support individuals across the EU self-managing at home with multimorbidity.

• Development of 3 new digital health implementation assessment support tools to better prepare EU organisations, regions and localities to implement and transfer digital health solutions.

• Development of EU recommendations and strategies to improve outcomes for digital health technology transfer, procurement processes and pathways towards person centred digitalisation of organisations that wish to address systematically the challenges of the digital revolution in their service delivery model.

Evaluating the effectiveness of the ProACT platform and associated SEURO tools will help provide key evidence within the EU to the effectiveness of digital health solutions for advancing citizen centric proactive health and well-being management as well as a community driven model of digital care for multimorbidity. This is an area previously under-explored within EU health systems which have historically focused on single disease frameworks of care. For persons with multimorbidity (PwMs) services are often repetitive, inconvenient, inefficient, burdensome and potentially unsafe, due to poorly integrated and coordinated care. This significantly impacts on individuals quality of life and increases the cost of care. To successfully deliver new innovative multiple disease care models, the EU must advance the use of digital health technologies. The use of SEURO tools with ProACT will help achieve this.
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SEURO - Consortium at SEURO Launch
SEURO - ProACT PwM CareApp Medication Management User Interface
SEURO - ProTransfer Prototype Results Section User Interface
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SEURO - Principal Investigators at Launch
SEURO - ProACT Pwm CareApp Activity and Weight Goals User Interface
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SEURO - ProBCF-Checklist (ProBCF-C) Prototype User Interface
SEURO - ProACT PwM CareApp My Dashboard User Interface
SEURO - Dr. John Dinsmore (Coordinator) receiving SilverEco International Ageing Well Award
SEURO - EU Researchers Night Trinity College Dublin September 2022